Dog Ear And Skin Excision Surgery

Offered at our convenient location in Raleigh, NC

Items To Obtain Prior To Surgery

  • Hibiclens soap (at any pharmacy, Walmart, or Target in first aid section).
  • Abdominal pads or thick gauze for after surgery.
  • Antibiotic ointment
  • Hydrogen peroxide
  • Cotton tip applicators
  • Alcohol wipes
  • Arnica gel tabs (these are on line). This helps with discomfort, bruising and swelling after surgery.
  • Absorbent pads for bed (urinary section of store).  There may be oozing after surgery and these pay help protect bedding.

Two Weeks Before Surgery

 • Do not take any products containing aspirin, ibuprofen (Advil, Motrin), non-steroidal anti-inflammatory medication or Vitamin E. Tylenol is acceptable.

 • Refrain from all nicotine products, including cigarettes, pipe tobacco, chew or Nicotine patch. Nicotine interferes with healthy circulation and may affect the result of your surgery. It also places you at higher risk of complication when receiving anesthesia.

One Week Before Surgery

• Do not drink alcohol for 1 week before and after surgery.

The Day Before Surgery

• You will receive a phone call informing you of your arrival time for surgery. 

• Ensure you have plenty of good healthy foods and beverages on stock for after your surgery. Plenty of protein, fruits and vegetables are always a good idea.

• Pick up your prescribed medicines and place them in a bag to bring with you the day of surgery.

• Wash with hibiclens soap the night before surgery. Also plan to wash your hair that evening or morning of procedure. 

• Relax and breathe! Last minute jitters are normal. 

Surgery Day

• Wash with hibiclens soap the morning of surgery. Wash all areas that will be worked upon. 

• Make sure to eat something before you come to avoid stomach upset, particularly if you are taking oral sedation. 

• Do not wear cosmetics, jewelry of any kind, contact lenses, hair clips or body piercings (If there is something you cannot remove, let the admitting nurse know right away.) Wear comfortable, clean, loose-fitting clothing: Do not wear jeans or any tightfitting bottom; rather have a pair of loose, drawstring sweatpants to wear home. You may wear a robe. Wear slip on, flat shoes with a slip proof sole; no heels. Wear clean cotton socks, as the operating room can feel cool. For your comfort, wear a zip or button front top.

Supplements

 • Do not take aspirin (or products containing aspirin) or Ibuprofen (Advil®, Motrin®, Midol®) for 2 weeks after surgery. Also do not begin herbal supplements until 2 weeks after surgery.  Arnica, Bromelin and Vitamin C are okay to take. 

• Phentermine or appetite suppressants should not be taken until 6 weeks after surgery as these supplements increase heart rate and blood pressure and can interfere with your recovery

Post-Surgery Instructions

• Do not drive for if you are taking any pain medications.  DO NOT DRINK ALCOHOL WHILE TAKING PAIN MEDICATIONS or muscle relaxer. This can be a deadly combination. Only take the pain medication if needed. The quicker you can wean off of the pain medication, the better you will feel and heal.

• Avoid any activities that cause pain or discomfort. 

• If you have taken any oral sedation, you will be required to have responsible adult transport you home. 

• Limit your activities for the first 24 hours after surgery. Walk for short distances during the first 24 hours after surgery. You should try to keep a flexed position in the torso at all times for the first 2 weeks. This keeps tension off the wound and reduces the chance of a widened scar. By the end of the second week, gradually begin to stand more upright. Keep your hips flexed while in bed to prevent excess tension at the surgical site.

• Resume activities slowly. You may feel tired for the first few days. Avoid heavy lifting, bending and straining for 4-6 weeks. You may resume all activity after six weeks. 

• Take all medications as instructed. You will be given a narcotic. Try to wean off this medicine after a few days. Most patients can change to Tylenol without major issues. If you are sleeping, you should not be awakened to take narcotics or muscle relaxants. These medications can make you even sleepier and over-sedated. Over-sedation can be dangerous and must be avoided.

• Swelling and bruising are normal. It is expected to take between 3-6 months to see your final results.

• Fluids and good nutrition are important following surgery. Consume non-carbonated, nonalcoholic, caffeine-free beverages including fruit juices, sports drinks, water, and yogurt drinks. You should drink at least 8 ounces of fluid every 2-3 hours. Nausea is common after surgery, so start with soft, bland, nutritious food for the first 24 hours.

• If you have not urinated after 6 hours of being home from surgery, please contact our office. 

• After surgery it is common that you will have a drain at the surgical site. 

• You may change the absorbent gauze pads that are placed at the surgical site as needed to help keep the incision clean and dry.

• You may shower (but not bathe) in 3 days after surgery. 

• A surgical garment will be applied immediately after surgery. This is to be worn continuously for the first week. After one week, you may remove the garment to shower. After showering, the garment must be placed back on and worn for six weeks. You may want to use a funnel to direct the flow of urine when using the bathroom to keep the garment as clean as possible. If you find that the binder is making you itchy, you may wear a tight kami shirt under your binder. You may also consider purchasing an additional corset or waist trainer for maximum compression. Recommend The Vanna Belt or the Bellafit corset or waist trainer.

Exercise And Sexual Activity

• No overheating for the first 3 weeks (spas, exercising in the sun, etc). 

• You may begin swimming 4 weeks post-operatively if healing is complete.

What To Expect

• Moderate swelling. The swelling will gradually subside and you will be back to normal in 3 – 6 months. Swelling will be at its worst between 3 – 5 days. Swelling starts to subside at 6 weeks but may take 6 months to resolve.

• Bruising is a normal expectation following surgery. Bruising could be apparent for as long as 3 – 4 weeks afterwards. The bruises will move down your body as they are absorbed.

• Infrequently after surgery, you may have fluid build up.  If you feel this area is enlarging rather than going down, please call the office. You may have what is called a seroma or fluid collection which needs to be drained.

• You will temporarily gain weight after surgery. This is caused by water retention, which is a normal hormonal response to the stress of surgery. Your face and hands may even swell due to this fluid retention. Don’t be concerned with this. Indeed, we advise that you do not even trouble yourself by checking your weight after surgery. The fluid will be mobilized and excreted by your kidneys in 1-2 weeks after surgery. 

• It takes 6 MONTHS FOR FINAL RESULTS to appear. In the interim, you may notice:

  • Be patient please and try not to focus on these issues before the 6-month period. 

• Numbness is expected to resolve by 9 months on average.

Emotional Exepectations Following Surgery

• It is not unusual for patients to undergo significant emotional “ups and downs” after any type of surgery. Factors such as underlying stress, medications, and/or psychological tendencies can result in patients experiencing a “postoperative depression” that generally resolves after a few weeks. Having a partner, family member, or friend who is supportive can help with this process. Understanding the stages of emotional “ups and downs” can help patients stay calm and recover from this emotional process faster: 

  • Phase 1: Being Out of It – Swelling and discomfort is most severe over the first few days after surgery. Pain medications also can make you disoriented and emotional. 
  • Phase 2: Mood Swings – Having just had surgery, patients are adjusting to a sudden change in their appearance with much anticipation. The presence of bruising, swelling, and asymmetries will distort a patient’s results thereby concealing the final outcome. Mood swings (especially sadness), worry and depression are common emotions as a result. Patients may even ask, “What have I done?” or think that “I never should have done it.” 
  • Phase 3: Being over critical – During the second week, patients will probably be feeling a lot better. The swelling and muscle cramping/spasms will be decreasing and sutures will be out. Because of anticipation, it is natural for patients to look critically at their new body worrying about symmetry, scars, and so on. At this point, it’s normal to wonder if they have achieved their goal and what they paid for. This is too soon to tell and most concerns are resolved with time. 
  • Phase 4: Happy at last – Finally, about 3 – 6 months out of surgery, patients will probably start liking how they look and are feeling much better. They may be in the mood to check out some bathing suits or outfits to show off their new figure.

Depression. Your body (including your brain) is exposed to great amounts of physiologic and mental stress after surgery. This is caused by a number of factors. Your hormone and steroid levels are elevated and you are taking medications (especially the narcotic and muscle relaxants) that directly affect your physiology and psychology. Your sleep cycle is probably disrupted, so you are likely sleep deprived. All of these factors, combined with the emotions and expectations you have invested in your surgery, can lead to a brief “let down” or “depression” after plastic surgery. As healing occurs, and as your physiology, stress level and sleep return to normal, these thoughts usually disappear. If you feel mildly depressed, understanding that this is a natural phase of the healing process may help you cope. If this happens to you, we want you to discuss it with us, especially if depression is severe. 

Traveling

• In most cases, you should plan to remain within a reasonable traveling distance of our office for at least a few days after surgery, in case you develop a problem requiring emergent or urgent attention. 

•  If you travel as a passenger at any time for the first month after surgery please take a travel break every 30 minutes.